As I said last time, I got some tough feedback, some of which made no sense but some of which was warranted. And I wanted to fix some of those issues this week, specifically my presenting.

I know what the general idea must be; you’re more than six months into residency and you’re having trouble presenting? The answer is yes and no. I’m not bad overall, but it’s been very hard for me to keep myself organized over the last few months for a number of reasons which you don’t think about as a medical student because they’re not problems you have to deal with. These include;

Being in charge of a significant number of patients while being responsible for them; the most any sub-I at our program has carried was 4 patients, and the most I carried between 3rd and 4th year was maybe 6? I don’t know what other people have experienced, but even if you’ve carried more, the difference of actually having to be right while formulating a plan of attack is a much more intense a process in a way I didn’t expect.

There usually isn’t time to sit down and work everything out on paper; I’m a big sit-down-and-work-it-out kinda girl so the 30-45 minutes in the morning we get to pre-round is not particularly great in terms of me getting my very disorganized brain into a slightly more organized place.

You rely on the night team to get your ahead during the day; because of the time crunch and sometimes out of hand patient load, you end up deferring to what the night team has written in sign-out which isn’t always right or complete. Which, as anyone who makes a mistake during a presentation knows, it sucks when you say the wrong thing. It’s not to blame the night team, but when everyone is crunched, no one wins.

Using sign-out sheets in general; they are not in a presentation format, and I know that’s not an issue for a lot of people by oh boy does it kill me.

You learn to present as a medical student. But like everything in medicine, the higher up you go the more details and obstacles appear but you learn to adapt.

All that being said, I went to our hospital fellow to start getting some help because I refuse to be that person. Especially since it was a fixable problem, I just needed help. She was so encouraging all week and really excited which I did not expect. I went to her with whatever time I had after rounds and discharges to go over how the morning went almost everyday and I really appreciated that she was as invested as I was in my improvement.

I think I improved over the week. It was time consuming. I had to do extra work on top of my already painfully full schedule.

There was an extra measure to account for this week, which I won’t go into too much detail because you never know who can see what, but it was just tough in general. And incredibly frustrating. I did a lot of reminding to my fellow intern on the floor that our team is having success despite the general discourse. The consistent flow from the PICU of kids who aren’t quite ready for the floor due to them being over loaded also made this week harder than most.

That’s what I signed up for though, right?

What I was reminded of this week is working to improve something and goal setting starts small, attainable milestones, and reevaluating after those small steps have been reached.

A successes in those little goals, make having to stay on a 24 that much less terrible.

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